JUST CLEAN SMILES, LLC (NPI# 1609176965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609176965 |
| Entity Type | Organization |
| Organization Name | JUST CLEAN SMILES, LLC |
| Practice Address |
1204 Main St Ne Suite B Los Lunas NM 87031-7409 |
| Practice Telephone | 5055650609 |
| Practice Fax Number | 5055650709 |
| Mailing Telephone | 5055650609 |
| Mailing Fax Number | 5055650709 |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2011-03-27 |
| Authorized Official Name | DONNA M RIORDAN (MANAGER/DENTAL HYGIENIST) |
| Authorized Official Telephone | 5055650609 |
| Authorized Official Credential | RDH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 1503 | NM | Dental Providers |
| Y | 124Q00000X | Dental Hygienist | DH-373 | NM | Dental Providers |
| Street Address |
1204 MAIN ST NE SUITE B |
| City | LOS LUNAS |
| State | NM |
| Zip Code | 87031-7409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366741530 | Donna Marie Riordan | Dental Hygienist | 1204 Main St Ne, Suite B, Los Lunas, NM 87031-7409 | 2011-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407466212 | Juanita Arcelia Flores-hull | Registered Nurse | 19670 Highway 314, Belen, NM 87031 | 2020-08-06 |
| 1184267171 | Nicole Andrea Bassett | Registered Nurse | 236 Don Pasqual Rd, Los Lunas, NM 87031 | 2019-10-22 |
| 1922649359 | Darrel Thompson | Physical Therapist | 2211 Main St, Ne, Los Lunas, NM 87031 | 2019-10-07 |
| 1407415235 | Brittany Leigh Dow | Family Medicine | 328 Main St Sw, Los Lunas, NM 87031 | 2019-06-05 |
| 1942764162 | Christine Beevers | Occupational Therapy Assistant | 310 Bonita Vista Blvd, Los Lunas, NM 87031 | 2019-01-23 |
| 1669953105 | Patricia A Ziehl | Occupational Therapy Assistant | 119 Luna Ave., Los Lunas, NM 87031 | 2018-08-23 |
| 1922500776 | Mellisa Marie Everett | Massage Therapist | 3414 Nm- 47, Los Lunas, NM 87031 | 2018-03-07 |
| 1831699917 | Nachelle Lynn Pell | Registered Nurse | 310 Bonita Vista, Los Lunas, NM 87031 | 2018-02-15 |
| 1053829135 | Valencia Denise Jackson | Registered Nurse | 46 Chacon Rd., Los Lunas, NM 87031 | 2018-01-11 |
| 1548777972 | Aja Santana Armijo | Speech-Language Pathologist | 46 Chacon Blvd., Los Lunas, NM 87031 | 2018-01-08 |
| Find all providers in zip 87031 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821396896 | Nicole S. Love | Dental Hygienist | 710 Primrose Ave Sw, Los Lunas, NM 87031-4857 | 2011-03-01 |
| 1881935849 | Dina Renee Martinez-valdez | Dental Hygienist | 145 Don Pasqual Rd Nw, Los Lunas, NM 87031-8841 | 2013-03-14 |
| 1366741530 | Donna Marie Riordan | Dental Hygienist | 1204 Main St Ne, Suite B, Los Lunas, NM 87031-7409 | 2011-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940787 | Carrie Boehm | Dental Hygienist | 2844 E Main St Ste 106-145, Farmington, NM 87402-5260 | 2020-10-16 |
| 1205450939 | Aislinn B Grover | Dental Hygienist | Indian Service Rte 140 & Indian Service Route 125, Pinehill, NM 87357 | 2020-05-28 |
| 1669095188 | Julie Arneson | Dental Hygienist | 11 Sacred Vista Rd, El Prado, NM 87529 | 2020-05-19 |
| 1013540848 | Kelsi Marie Hartwig | Dental Hygienist | Highway 491 North, Yucca Street, Shiprock, NM 87420 | 2020-02-20 |
| 1841839099 | Naomi Lynn Amador | Dental Hygienist | 105 Golf Dr, Clovis, NM 88101-3145 | 2020-01-04 |
| 1972061539 | Mary Hilley | Dental Hygienist | 33 General Sage Dr, Santa Fe, NM 87505-6397 | 2019-03-03 |
| 1568930782 | Janelle K Mancha | Dental Hygienist | 9527 Night Sky Ln Ne, Albuquerque, NM 87122-1252 | 2018-11-06 |
| 1063988301 | Sarah Adele Sisneros | Dental Hygienist | 333 San Mateo Blvd Se Ste A, Albuquerque, NM 87108-2919 | 2018-10-14 |
| 1356825186 | Roberta Rodriguez | Dental Hygienist | 15136 St Hwy 75, Penasco, NM 87553 | 2018-09-18 |
| 1285125658 | Alicia T Medrano | Dental Hygienist | 1105 Golf Course Rd Se Bldg A, Rio Rancho, NM 87124-4733 | 2018-05-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.